The age old conundrum of whether to continue extended section 17 leave or not

The Upper Tribunal recently considered an appeal by SL in the case of SL v Ludlow Street Healthcare. The question the tribunal had to consider was “when will a patient who is living and receiving treatment outside hospital, remain liable to be detained in a hospital for treatment?”  

SL was required to attend fortnightly psychology sessions and a monthly ward round.

Having considered the appeal, Judge Jacobs confirmed that there was no error on a point of law in the Welsh tribunal’s decision and stated, at paragraph 36, that he was “satisfied that the tribunal applied the correct test”. He particularly looked at the definition of medical treatment under the Mental Health Act 1983.

When considering if a patient should remain on long term section 17 leave, Judge Jacobs stated, at paragraph 34, that “it involves looking at each case and the patient’s treatment realistically, as a whole and as part of an ongoing process”. In addition, he noted that while “the actual rehabilitation and care was delivered outside the hospital, the form that it took was under the ultimate control and supervision of the clinical team” who were based within the hospital.

This will be a familiar scenario for treating clinicians. However, there remains the need to carefully consider whether extended section 17 leave is appropriate or whether, in fact, the patient should either be discharged from the MHA or be made subject to a Community Treatment Order.

Where patients are on extended section 17 leave, clinicians should ensure that alternatives are considered and if not appropriate, reasons are adequately recorded within patient records and communicated with the patient. If you are unsure of the appropriateness of extended section 17 leave, please contact Molly Sanghera and she will be happy to assist you further.

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